This page covers a specific first-line protocol for temporomandibular joint syndrome presenting with acute, severe myogenous pain alongside restricted mouth opening — with or without disc displacement without reduction.
The patient has acute severe myogenous pain and difficulty opening the mouth. Disc displacement without reduction may or may not be present. This precise combination defines eligibility for this therapeutic approach — it is not indicated for milder or purely articular presentations.
The protocol involves a short-course oral medication, subject to formal assessment of medical and social contraindications before prescribing. An early review is built into the regimen. The clinical target is resolution of the acute severe myogenous pain by that review point. The complete regimen, eligibility criteria, contraindication checklist, and review schedule are available in the full structured protocol.
Their therapeutic role is restricted to instances of acute and severe myogenous pain with limited opening (+/- disc displacement without reduction).
In such cases diazepam 2 mg up to three times daily, for 5 days initially, up to a total maximum duration of 2 weeks if symptoms remain at the 5-day review may offer benefit for some cases.
Medical and social contraindications must be assessed and National Institute for Health and Care Excellence (NICE) prescribing information for Diazepam in TMD available here must be followed.
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